We report a case of a large maxillary sinus mucocele in a 14-year-old girl presenting with epiphora, proptosis and dental pain. This was marsupialized endoscopically, with complete resolution of symptoms over three months’ follow up. The literature is reviewed.

Antral washouts have been widely used in the management of chronic sinusitis. With the advent of modern antibiotics and powerful topical nasal steroids, we sought to establish if a role remains for this procedure.

One hundred and fourteen patients with chronic sinusitis were randomised into two groups. Patients in Group A received antral washouts followed by antibiotics and topical nasal steroids. Patients in the Group B received antibiotics and topical nasal steroids alone. In each group 51.6 percent and 50 per cent of patients respectively improved with treatment. The outcome of treatment is also not influenced by endoscopic abnormality. The difference was not statistically significant (p = 0.86). The study indicates that half of patients with chronic sinusitis will improve with medical treatment but the addition of antral washout confers no additional benefits.

Thirty New Zealand White rabbits underwent unilateral partial or complete removal of maxillary sinus mucosa in order to evaluate submucosal maxillary sinus glands. After three months, specimens were taken for examination from all operated on and control sinuses. Bacteriological cultures, light and electron microscopy were performed. Histopathological findings showed a decrease in the number of serous glands and significant inflammation was present in the sinus in which there was complete surgical removal. Electron microscopy revealed changes in the secretory cells of the serous glands in the regenerated postsurgical mucosa.

Maxillary sinus disease can lead to dehiscence of the orbital floor. Using endoscopic sinus surgery it is possible to simultaneously reconstruct the orbital floor and to assess and treat underlying sinus disease.